How long does gallbladder surgery take? Step by step from preparation to recovery

A few days before a planned operation, these tests are usually done:

• complete blood count and urine test, blood clotting tests, blood group;
• biochemical tests: liver enzymes, bilirubin, glucose;
• tests for hepatitis B, C and other infections;
• an electrocardiogram (ECG), and, depending on your age and condition, an opinion from an internist or cardiologist;
• a recent ultrasound (US) to clarify the condition of the stones and bile ducts.

Medications. If you take blood thinners, diabetes medication, insulin or hormonal drugs, tell us in advance. Your doctor decides whether to stop them or change the dose; don't stop them on your own. If you smoke, the sooner you quit before surgery, the better for your breathing and for wound healing.

Fasting. For the safety of anesthesia, the stomach must be empty. Usually, you stop eating 6 hours before surgery and stop water and other clear fluids 2 hours before. We give you the exact times separately.

Fear of anesthesia. This is one of the concerns we hear most often. Before surgery, the anesthesiologist meets you separately: they ask about the condition of your heart and lungs, allergies and how you tolerated earlier anesthesia. Modern anesthetic drugs are short-acting, and you usually wake up soon after the operation ends. Throughout the operation, your pulse, blood pressure and breathing are monitored continuously. Feel free to ask the anesthesiologist any questions.

What to bring: comfortable clothes, an ID, the medications you take, and your earlier test and ultrasound results. Have someone with you for the trip home.

The day of surgery goes roughly like this:

Factors that can make the operation longer:

• acute or long-standing inflammation, thickening of the gallbladder wall;
• adhesions left from earlier abdominal surgery;
• excess weight;
• a stone in the bile duct;
• an additional procedure done in the same session, for example, repair of an umbilical hernia.

Inflammation that has lasted for years can turn a laparoscopic operation that would usually be simple into a difficult one. This is one of the reasons not to wait for years with a stone that causes symptoms. These times are approximate; the exact time is given after your examination.

Cholecystectomy is the removal of the gallbladder together with its stones. The laparoscopic operation goes step by step like this:

1. General anesthesia. The anesthesiologist gives the medication through a vein, you fall asleep and feel nothing throughout the operation. Your breathing is supported by a machine, and your vital signs are monitored continuously.
2. Small incisions. Three or four incisions, each 0.5–1 cm, are made in the abdomen. One is usually near the navel.
3. Carbon dioxide and camera. Carbon dioxide is introduced into the abdominal cavity so the organs can be seen clearly. The camera sends the image to a screen, and the surgeon works with thin instruments.
4. Separating the gallbladder. The duct and artery of the gallbladder are closed with special clips, and the gallbladder is separated from the liver.
5. Removal. The gallbladder, together with its stones, is taken out in a special bag through the incision at the navel and is usually sent for histological examination.
6. Closing the incisions. The gas is released, the incisions are stitched and a dressing is applied. Sometimes a thin drainage tube is placed for one day.

In a small number of patients, because of severe inflammation or adhesions, the surgeon may switch to open surgery for safety. In that case, the hospital stay and recovery are somewhat longer.

Laparoscopic and open surgery: what is the difference?

Today, most gallbladder operations are done laparoscopically. Open surgery is mainly chosen in difficult cases, and sometimes it becomes necessary to switch to it during a laparoscopic operation.

After you wake up, you may feel sleepy for a while; this is normal. In the first hours:

• walking: you can usually get out of bed and walk after 4–5 hours. Moving early lowers the risk of blood clots and lung complications and helps the gas pass;
• food: at about the same time, you can drink water and tea and eat light food such as soup;
• pain: there is pain at the incision sites, and it is usually kept under control with ordinary painkillers. Sometimes the right shoulder hurts too: the carbon dioxide introduced into the abdominal cavity irritates the diaphragm, and this pain passes in 1–2 days;
• nausea: it can occur after anesthesia and is relieved with medication when needed;
• breathing: taking deep breaths from time to time helps the lungs expand fully. When you cough, pressing a pillow lightly against your abdomen reduces the pain.

Suitable patients can be discharged on the evening of the operation. For this, pain must be under control, you must be able to walk, eat, drink and urinate, and someone must be with you at home. With acute inflammation, serious accompanying illnesses or after open surgery, patients usually go home the next day or a few days later. Don't drive yourself home.

• Wounds: change the dressings according to your doctor's instructions. Showering is usually possible after 1–2 days; baths, pools and saunas are not allowed until the wounds have healed.
• Activity: walk several times a day, but don't lift heavy loads or strain your abdominal muscles.
• Pain: take the prescribed painkillers as directed. The pain should ease every day.
• Bowel: in the first days you may have constipation or, on the contrary, soft stool. Drink enough fluids and don't strain on the toilet.
• Sleep: for the first nights, sleeping on your back or slightly on your left side is usually more comfortable.
• Sex: you can usually return when you feel comfortable, after one or two weeks.
• Follow-up examination: usually after 7–10 days, the wounds are checked and the histology result is discussed.

After the gallbladder is removed, bile flows into the bowel constantly, in small amounts. At first, it can be hard to digest a large, fatty portion all at once. That is why:

• first 1–2 days: water, clear soup, porridge, yogurt, cooked vegetables;
• first 2–4 weeks: eat 5–6 times a day in small portions; choose lean chicken and fish, porridges, cooked or steamed vegetables, fruit and low-fat dairy products;
• limit: fried food, fatty meat and lard, a lot of butter and cream, fast food, spicy food, fizzy drinks and alcohol;
• afterward: bring fatty foods back into your diet gradually, in small portions, and watch how your body reacts. Increase fiber-rich foods slowly too.

Sample menu for the first week:

• morning: oatmeal, yogurt, baked apple;
• midday: vegetable soup, boiled chicken, rice;
• snack: kefir, banana, dried white bread;
• evening: steamed fish, boiled vegetables or mashed potatoes.

This is only an example. If you have a condition that needs a special diet, such as diabetes, adjust the menu with your doctor. Most people return to a normal diet after a few weeks; a strict lifelong diet is usually not needed.

These times are averages for laparoscopic surgery; recovery after open surgery takes longer. The exact time is given after your examination.

The gallbladder is not a vital organ. The liver keeps producing bile; it just flows directly into the bowel instead of being stored. Most people live normally after surgery and are free of their earlier colic and nausea.

In some people, stool may become soft or loose after fatty meals in the first weeks. This usually eases over a few weeks, sometimes a few months. If pain continues after surgery, the cause, for example a stone left in the bile duct or a stomach problem, is investigated and treated.

For women: removal of the gallbladder does not prevent a future pregnancy or delivery. You can read our patients' real experiences on the patient stories page.

In the following cases, don't wait; seek urgent care:

• a fever above 38 °C (100.4 °F), chills;
• abdominal pain that gets worse instead of easing every day, a swollen or hard abdomen;
• yellowing of the whites of the eyes or the skin, dark urine, light-colored stool;
• repeated vomiting, being unable to keep down water and food;
• pus or a greenish-yellow discharge from a wound, redness and swelling around it;
• shortness of breath, chest pain, pain and swelling in the calf.

If you haven't had surgery yet and biliary colic keeps coming back, especially if a fever or jaundice is added, don't delay seeing a doctor.